Hi Everyone,

It's been really busy around here but there is something I wanted to share with you.
I recently went on vacation to Washington DC and at the Smithsonian Museum of Natural Science there was a "Bone Display".  It was very interesting;  mostly sharing about how people's bones have gotten healthier since colonial days.  I was surprised to see that they actually had some broken bones with pins and plates in the display, showing the museum goers how broken bones are healed with hardware.  I'm posting them for you to see, since we don't often get to see what is residing in our bodies.  Keep in mind that these photos are from pretty extreme breaks, thankfully most of ours are not as bad.

This is a tibia with a really bad break.

A tibia with a lower break.  Notice how the skin grew over the hardware?

This poor person had a massive injury on the femur. OUCH! Serious hardware!

Wow, this is a terrible broken tibia!

August 2012 Update

My knee is feeling better thanks mostly to the physical therapy.
I have been given a list of exercises to do to increase the strength of the quad muscles and to stretch the tightness of the calf.

Here is my daily routine:

• Slowly raise and lower left leg while on back (right leg bent), 3 sets of 15.
• Slowly raise and lower left leg while on side, 3 sets of 15.
• Bridge exercise to strengthen the gluts, 3 sets of 20.
• Sets of writing alphabets with heel while leg is raised, 2 full sets on back and also on side.
• Stand on each leg without holding on, 3 times a day minimum 30 seconds, both legs.
• Stretches of the calf, throughout the day.
• Exercise bicycle 40 minutes a day.
• Walking throughout the day, 20 minutes minimum.

It may seem like alot to do, but it does go by fast and you can really tell when you miss a day or run out of time. I have to make this a priority for myself. I am amazed how weak my left leg was. Don't let this happen to you!

I'll be back in awhile to update you on my plantar (foot) problems.

Slightly Set Back

I would say my TPF was a great success on the whole. I have been dealing with a slight setback lately. And it's a long story....

In March 2012 I developed a case of plantar fasciitis. This is where you have sharp pain in the heel of your foot. Of course, mine is in the left foot, which is the side of my broken leg. There are plenty of self-help tips and videos on the internet so I did my homework and did everything to try to facilitate my recovery from this painful injury.

Things didn't seem to be improving, or more accurately, I was having good days and not so good days. The pain in the foot became so bad that I gave up almost all physical activity. Especially walking, which is my favorite thing to do.

Towards the end of May (near my 2 year anniversary) I really panicked because I was now getting knee pain. The knee would swell and hurt. This was definitely not good. I could deal with heel pain, but new knee pain was something I had to get checked out.

I went to my GP and he sent me for xrays. The xrays said that I had arthritis in my knee. Holy smoke, this was devastating news. I knew that "knee" and "arthritis" in the same sentence is so NOT good for the active lifestyle I want. I think every person that has a TPF has extreme anxiety about this. My GP then sent me to the podiatrist who gave me a pep talk about everything I already knew about plantar faciitis. I asked him if my knee problems were related to my heel pain and he answered, "it's possible". Not very helpful. But he was a nice man.

I was in denial about "knee" and "arthritis" for a few weeks and then made the call to my orthopedic surgeon for an appointment. If I had arthritis I wanted to know how bad it was and what I could expect. It took me 3 weeks to get an open appointment.

My OS has always been a very personable woman and she and I have good rapport. She didn't see my xrays ahead of the appointment was was prepared for the worse when I told her what had happened to me. So she pulls the xray up on the computer and stared for a good few minutes. She said she couldn't find arthritis on my knee. She showed me the holes where my screws were, where my break was, where the plateau was smooth but no arthritis. I immediately felt like a giant weight went off my shoulders. I trust her 100% since she has been my doctor throughout my whole ordeal.

Now the only problem was, what was causing my knee pain? She seemed pretty puzzled until she had me flex both legs and she told me immediately that the right leg was way stronger than the left and that was probably the cause of my problem. She have me a referral for physical therapy and wished me well.

We stopped by the PT area on our way out to get an appointment. The nice lady at the desk said she had a cancellation and I could be seen in 45 minutes. I didn't want to wait and she told me that the soonest she could get me in would be 2 weeks. Okay, I'll take today's appointment.

After doing a series of exercises to show the strength of my legs, my PT gave me a set of exercises to go at home. He said that yes, my left leg was significantly weaker than my right. Sigh.

Two weeks later the knee is feeling better. The swelling is pretty much done. I still have some pain with my foot and I'll be going to the podiatrist tomorrow for some help with that issue.

Bottom line: Keep your muscles strong around the knee, especially the quads! I'm glad that my problem wasn't with arthritis, thank goodness!

My Top Tips from my TPF

This week marked my two year anniversary of my TPF. I thought I would answer a few questions that might come up in hope that you can better understand this injury. Everything I read in the beginning was super negative and, after two years, my life (and my leg) are pretty  normal. This, of course, didn't take two years so don't be discouraged!

Just remember, I'm not a doctor nor have I had any special medical training, so just take this as friendly advice on what worked for me. Please check with your doctor always!!

I'll try to add more topics as I can think of them!

How long for pain pills?
While some people had bad side effects with pain killers, I was not one of them. Some folks feel the need to be stoic and get off the meds as soon as they can, and that is great for them. I was told that pain management needs to be a priority in your recovery. Don't let the pain get away from you or else it will be very hard to get it back under control. I remember that I gave up the pain meds during the day way before giving them up at night. I did have a good amount of night pain--you know, where it was throbbing and I couldn't get comfortable so I could sleep. I'm a believer that a good night sleep will do you a whole lot of good, so I would take a Vicoden at bedtime and had a spare pill and some water on the bedside table in case I would wake up in pain. At least once a week I would try to cut the meds down to half or I would try to skip the second dose. When you do cut down your meds, make sure to go slowly to avoid unpleasant side effects.

No cast?
I was quite surprised I was sent home from the hospital without a cast, only a brace. And then my doctor told me to put aside the brace and not wear it. This made no sense to me and I was really afraid to put it away. Now I know that the "cast" is internal and it is not necessary to have an outer cast. I did wear my brace when I went outside just in case I made a slip and just for my own peace of mind. Lucky for me, I never once had a slip up and I think that is because I used a walker and not crutches.

Will I need a knee replacement?
I first read about this problem early in my healing. It seems that some doctors tell their patients that you can expect a whole host of problems with your knee down the road. Of course, I had to talk to my doctor at length about this and she said the following. She has done many, many surgeries for TPFs and she has done only two knee replacements on these people One was in the patient's other leg, and the other patient was well on her way to a replacement before she broke her leg. Another doctor told me that if you are prone to arthritis having a TPF will not help/hurt that fact. I can't spend my life worrying about if I need one down the road. My hope is , if I do need one, the technology will be improved by then so it won't be so bad.

What to expect when finally weight bearing?
As soon as I came home from the hospital I wrote down the date on the calendar when I could bear weight. I was excited! When the date came I was very surprised to find I was really nervous. Really nervous and fearful that something bad would happen to my leg. Well, picture this. Here I am at the physical therapist's office and she tells me to stand up and put a slight amount of weight on my bad leg. My heart was pounding. I was sweating. I thought my leg would snap. But, as is sometimes the case, my imagination was worse than reality. It felt funny, but not bad. She told me to sway side to side, which I did. Still felt pretty good. She asked me to walk a few steps without putting a lot of weight on the bad leg. I was given a list of homework to do and was exhausted just by stepping on the bad leg.

Helpful exercises for me?
There are a few exercises that were very helpful for me. In the early days, I did a lot of stretching. I got a towel and made a narrow strip out of it. I would stretch and bend with the help of the towel at least 3 times a day. Lucky for me, I had good range of motion pretty early in the game.

For my birthday I got a recumbent exercise bicycle. This was very, very helpful in building back the strength in the leg. This in turn stabilizes the leg, which means less pain in walking. I wish I would have got one early in the game. You can get them cheap on Amazon and they are delivered to your home. Get one; you'll be glad you did!

Vitamins?
I'm not a super type of vitamin person, although I have been taking them for years.  Whether or not they really do work is something you have to decide.  I do have to recommend that if you have a broken bone, you take calcium and Vitamin D.  My surgeon is a big proponent of taking Vitamin D, especially.  She feels it is absolutely necessary for bone health.  And being a woman, taking calcium is something I've done for years.


Hardware removal?
You may get to the point where your hardware if hurting you, or maybe you just want it out.  Talk to your OS to see what your options are.  I was all hell-bent in getting it out myself.  It is not a difficult operation to recover from, especially after your initial break, but I would caution you that it is not as easy as some suggest.  I have read that some call it a "piece of cake"  I wouldn't go that far!  Surgery is surgery and you are adding additional trauma to your already traumatized leg.  Everyone is different so do what you and your doctor feel is best.

Hardware Removal 101, or Taking It All Out!

On October 18th, 2011 I had my plate and 5 screws taken out.

Here are some thoughts on that.

October 21, 2011

Thought I would tell you all about my hardware removal (3 days ago) in case you are interested!

I checked into the hospital at 7 am. It was deja vu! At least this time I ~walked~ down the hallway into pre-op! I was scheduled to go off at 9 a.m. but I was delayed until 9:20 a.m. The procedure was supposed to be 65 minutes, but Al said the doc was done with my after 45 minutes! Guess that is good in the fact that the metal came out easy.

I was in recovery for about an hour. When I woke up from the anesthesia I had no idea where I was or why I was there. What a weird feeling! So I was on my way home around noon. They didn't give me any crutches but I was wheeled out in a wheelchair. They put a lot of bandages around my leg and told me to leave them on until my post op visit (next week). So, I don't even know what my leg looks like. I do know that I can't have a shower for a week, but at least I can give myself a sponge bath this time while standing on my own two feet!

My pain level was a little high when I was first home. I was more concerned that I couldn't hardly bend my leg. My OS told me to try to bend it as much as possible without going overboard. It felt really tight when I tried to bend it the first day. It was awful to walk peg-legged again!

After 24 hours my leg hurt more than the first day. It felt like it was bruised and sore. Nothing that the Vicodin couldn't handle, though. I was getting by one crutch, but found by mid-day that it was much easier to get around without it.

My OS told me I could do some light pedaling on the stationary bike. I couldn't hardly make it around the first time because my leg was so tight, but after the first round it came much easier and really made my leg feel better. I am no hero about forgoing pain meds, but really after yesterday I wasn't in much pain at all so I quit taking them.

I am wobbly with my walking and haven't ventured outside the house. It is easy to stand and put weight on it, though. I can't tell how much swelling I have because of the big wrappings on the leg.

My biggest issue is that I have caught a cold and have spells of coughing and a runny nose. I haven't had a cold for years, and couldn't have picked a worse time to get one! All and all this procedure was nothing like the original one. It really makes me appreciate how much we all go through with our original surgeries.

I'll send you all an update after I see my OS next Wednesday and I'm able to see how bad my "new" scar looks!


October 27, 2011
Today (October 26, 2011) I went for my follow up and to have my stitches taken out. I should say "to get my ~stitch~ out. They finally removed my mummy wrap of bandages and I was very surprised to see no staples, like I had on the first go around. Instead, my OS told me she did a "cosmetic" stitch, which is one long stitch (sort of like a corkscrew) where they tuck the old scar down into the fresh scar. I don't think I'm doing a good job of explaining this, but she said it will make a really better looking scar once it's healed.

I noticed my scar is now bigger than the first time. She said because the bottom anchor screw (the one that holds the bottom of the plate flush) was difficult to get out. The top 4 screws (the big ones) came out very easily, she said.

Well, on the whole it looks pretty good. I can now feel the metal being gone. I do have some swelling near the incision, but when that subsides I won't see the bulky bulge where I had the plate. I did have some bruising along the medial side of the shin (I don't want to know how that happened).

After one week, my leg feels pretty darn good. I don't have complete ROM as before, but think that will come when the swelling subsides. I'm really happy that the pain of this was much less that I anticipated. Maybe after having it put in, nothing can compare, pain wise! I can walk almost normal, although I haven't tried walking any long distance yet. I can stand on it pretty much as before. Best yet, that "rubber band" feeling in the knee is gone. My knee feels "free" if that can be a word to describe it.

I'm really happy with my HRW removal and if your doctor says, "yes", hey I say, "go for it".

November 2, 2011

Here's my two week update for my HWR on October 18, 2011

It's been two weeks since the surgery and one week since I got the stitches out. The leg feels really good overall. I have a lot of bruising around the incision site. It doesn't look very pretty, but it is getting better. I still have quite a bit of bruising on the medial shin, although it is already yellow and fading. I still have a fair amount of swelling at the incision site, which I suppose would be normal. So, between the bruising and swelling it's not very pretty.

I am pretty much doing everything as before, with the exception of long walks. I think when the swelling and bruising goes down walking longer distances will be easier. I also walk a little bit slower than before. The ROM is almost 80+% of what it was before. I'm sure if I wanted to push it I could get more ROM, but I am not eager to test the stitches to the limit. I'm sure when the swelling goes down the ROM will come back.

As far as pain, I get some minor throbbing at night, but nothing too bad. Like I said, I am a big baby with pain and this procedure was much less than painful that I expected.

Another odd thing, my original scar was on the side of my left leg, and the removal scar is more about halfway between the old scar and the kneecap. And it is bigger than the original scar, but my OS told me that ahead of time.

It's a great feeling not to have that bulky plate in. It feels like taking off shoes in the evening and letting your toes wiggle around! Free!

November 17, 2011

I hit the 4 week mark yesterday and the leg is feeling really good. The bruises are still there, but the swelling has gone down a lot. I was surprised how much I bruised--maybe my OS didn't have a light touch!

I had to wear my bandages (size of King Kong, too) for a week. I was a bit disturbing to have it taken off, since there was a lot of dried blood on the wrapping. And the scar was (and still is) rather ugly to see, especially since the original scar was just a thin white line when I went in to the HWR removed!

Take it easy for a few weeks. Although you feel good your body has had another major trauma and needs to time to heal.

December 25, 2011

I had this exact same question after my removal and my OS told me to bend and stretch it but do so within reason. So no deep knee bends for awhile (hahaha). Actually just doing some light pedaling around my little exercise bike really, really felt good. I had a LOT of swelling so I knew from last time that I wouldn't get too distressed if my ROM wasn't up to the old standard. Sure enough, when the swelling went down, the ROM returned. My advice to you is not to worry too much about the ROM; it will come back. Concentrate on your healing.

BTW, my husband keloids really bad and I don't think there is much you can do about that. He is very self conscious about past scars and in time they will fade. I don't keloid and my scar still looks kinda bad, and it's been 3 months. The scar from the HWR, is much bigger than the original surgery but I'm hoping with time it will improve.

January 14, 2012

If I had any advice for you it is for you to take it easy and expect some pain. Some of the posts suggest it is a "walk in the park" but that wasn't my experience. Yes, you will walk out. Yes, you will notice rapid improvement. Keep up on the pain meds as you need them and don't overdo for a few weeks. It still is a major deal opening you up and taking out the metal.

January 28, 2012

yes, my original scar was used as the starting point for my removal work. Unfortunately for me, they had trouble getting the bottom screw out (the anchor for the bottom of the plate) and had to cut me longer than the original scar. So, my original TPF scar was maybe 4 inches, and the HWR scar is about 6. My OS did what she called a "cosmetic cut", which I believe was where the original scar was tucked inside the new scar. Also, my TPF scar was very much on the lateral (left) side, while the HWR scar is more right, or towards the knee cap. Not to worry, though when you see how wonderful it is to have the metal gone!

Three Month Hardware Removal Update

It's been 3 months already since my hardware removal. Things have really gone very well. The leg feels really good. I feel confident that I can push the leg harder now. Walking is easy, as is going up and down the stairs. My scar is still ugly, but is looking better. When I stand up on the leg for long periods the leg feels like it is still swelling, especially on the laterial side where the hardware was. The brusing is now gone, although it took a good six weeks to go away.

I have to recommend removal, if that is a option for you. I was thankful that my doctor was very willing to remove it. She told me it was my decision. She said the hardware served it's purpose and wasn't necessary for the intregity of the leg.

The whole broken leg road isn't an easy one to travel, but having the hardware out feels like the end of the journey is at hand.